Fewer Options for Mums Seeking Natural Births

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Midwives are protesting the shuttering of Manhattan's only natural birth center that served women on Medicaid. At the nation's oldest public hospital, administrators are ending a 12-year-old effort to provide low-income mothers with natural birth options.

The Birth Center at Bellevue Hospital was designed for the kind of birth experience that many moms, even the well-connected, find elusive. Labor was to unfold in spacious, comfortable rooms with sweeping views of the East River; midwives would massage women through labor pains; and world-class obstetricians would be at hand to address any complications. All this in a public hospital that primarily serves low-income patients and the uninsured, many of them immigrants.

So when hospital administrators quietly shut down the 12-year-old center this September, New York's tight-knit community of midwives and natural birth advocates demanded another look ...

A low-tech approach

... Like most hospitals, Bellevue has seen a steep climb in its overall c-section rate, from 18 percent of births in 2000 to 27 percent in 2007. Over the same period, the birth center maintained a c-section rate below four percent ... women admitted to the birth center were unlikely to experience labor complications ...

According to some midwives ... many Bellevue nurses proved unwilling to accommodate the pace of labor in the birth center ... hospital regulations require that a nurse be on hand to document and monitor every patient ...

For nurses, birth center procedures tend to be more time-intensive than those in standard labor and delivery rooms. Technology makes a difference: In the L&D suite, the laboring mother is hooked up to a monitor that measures her contractions and fetal heartbeat. This technology allows nurses to track the birth remotely, though it also constricts the mother to her bed. In the birth center, the mother is free to move around, and nurses check the fetal heartbeat intermittently with a handheld device. The low-tech approach requires more hands-on attention from attending nurses and midwives.

... Although Bellevue does not plan to reopen the birth center, women can still have a low-tech, midwife-attended birth in one of the standard delivery rooms ... The hospital will retain the midwives currently on staff ...

Even as the Bellevue center remains under lock and key, demand for such facilities is on the rise across New York City. Attending midwives at St. Luke's-Roosevelt Hospital keep waiting lists of mothers who want to use the hospital's birth center. At St. Vincent's Hospital, the planned Eli & Abby Manning Birth Center will offer acupuncture, hydrotherapy and other forms of natural birth support.

Neither center, however, is focused on the working class, immigrant-heavy population that defines Bellevue ...

Melissa Maimann, Essential Birth Consulting 0400 418 448